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Clinical Investigations

Determination of Association of Hyperchloremia with Rise in Inflammatory Markers, Serum Creatinine and Anaemia in COVID-19 Patients in Intensive Care Unit – A Prospective Follow-up Study

Authors:

Vedaghosh Amara,

Asian Institute of Gastroenetrology, Hyderabad, IN
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Souvik Chaudhuri,

Kasturba Medical College, Manipal, IN
About Souvik
Manipal Academy of Higher Education
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N. R. Arjun,

Kasturba Medical College, Manipal, IN
About N. R.
Manipal Academy of Higher Education
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Shwethapriya Rao ,

Kasturba Medical College, Manipal, IN
About Shwethapriya
Manipal Academy of Higher Education
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P. Vishwas

Kasturba Medical College, Manipal, IN
About P.
Manipal Academy of Higher Education
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Abstract

Hyperchloremia leads to adverse effects like increase in pro-inflammatory mediators, anaemia and renal dysfunction. Aim of this study is to determine the association of hyperchloremia with rise in C-reactive protein (CRP), serum ferritin, lactate dehydrogenase (LDH), serum creatinine and anaemia in COVID-19 patients in intensive care unit (ICU). It was a single-centre study, 62 COVID-19 patients participated. Change in CRP, serum ferritin, LDH, serum creatinine, haemoglobin between day one and day three of ICU admission were noted. Outcome in terms of in-hospital mortality was noted. Hyperchloremia (>106mmol/L) or rise in chloride by > 5mmol/L was seen in 13/62 (20.96%) patients. It was not associated with a rise in CRP, ferritin, LDH, creatinine, drop in hemoglobin within 72 hours or in-hospital mortality. 44/62 (71%) patients survived and were discharged from hospital. Multivariate logistic regression showed that if age and gender are also considered, there is a 25 times higher chance of having had a significant ferritin rise (> 95 ng/mL) in 72 hours of ICU admission among those who died. (p=0.01). Hyperchloremia (>106mmol/L) or a rise in chloride by > 5mmol/L in 72 hours of ICU admission was not associated with a significant increase in CRP, LDH, ferritin, serum creatinine within 72 hours of ICU admission or mortality in moderate-severe COVID-19 patients. If age and gender are taken into consideration, there is a 25 times higher chance of having had a significant ferritin rise (> 95 ng/mL) in 72 hours of ICU admission among those who died.

How to Cite: Amara, V., Chaudhuri, S., Arjun, N.R., Rao, S. and Vishwas, P., 2021. Determination of Association of Hyperchloremia with Rise in Inflammatory Markers, Serum Creatinine and Anaemia in COVID-19 Patients in Intensive Care Unit – A Prospective Follow-up Study. Sri Lankan Journal of Anaesthesiology, 29(2), pp.95–102. DOI: http://doi.org/10.4038/slja.v29i2.8882
Published on 16 Nov 2021.
Peer Reviewed

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